Unusual complication of strabismus and lid surgery

A patient with longstanding dysthyroid eye disease developed a broad adhesion between the globe and the upper eyelid following simultaneous surgery to recess the levator palpebrae superioris and lateral rectus muscles. This unusual complication may have developed as a consequence of failure to suture the conjuctiva of the upper fornix to the tarsus and also due to the prolonged static contact between the resulting adjacent raw areas due to postoperative eyelid traction and pressure dressings. Periods of such contact may have been further prolonged by the action of diazepam, which reduces the peak velocity of saccadic eye movements and suppresses rapid eye movement of sleep. Eyelid surgery should be performed as a separate procedure, under local anesthetic after healing of areas bare of conjunctiva from strabismus surgery utilizing the adjustable suture technique.